tbuckley/cabot-search huggingface dataset:
General Exercise Training Improves Ventilatory and Peripheral Muscle Strength and Endurance in Chronic Airflow Limitation
Authors: DENIS E. O'DONNELL, MAUREEN McGUIRE, LORELEI SAMIS, KATHERINE A. WEBB
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV1 = 41 ± 3% predicted; mean ± SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (VLIM), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 ± 8%, 43 ± 10%, 12 ± 5%, and 34 ± 9%, respectively (p < 0.05); quadriceps strength increased 21 ± 5% (p < 0.01); MIP and MEP increased 29 ± 11% and 27 ± 11%, respectively (p < 0.05); VLIM increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production (V˙ co 2), oxygen consumption (V˙ o 2), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): Δ B correlated with Δ F (r = 0.58, p < 0.01). Increased MIP and VLIM did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance. O'Donnell DE, McGuire M, Samis L, Webb KA. General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation.
Cancer screening in the United States, 2015: A review of current American Cancer Society guidelines and current issues in cancer screening
Authors: Robert A. Smith, Deana Manassaram‐Baptiste, Durado Brooks, Mary Doroshenk, Stacey Fedewa, Debbie Saslow, Otis W. Brawley, Richard Wender
Journal: CA A Cancer Journal for Clinicians (2015)

Abstract Answer questions and earn CME/CNE Each year, the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection along with a report on data and trends in cancer screening rates and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines. The latest data on utilization of cancer screening from the National Health Interview Survey (NHIS) also is described, as are several issues related to screening coverage under the Affordable Care Act, including the expansion of the Medicaid program. CA Cancer J Clin 2015;65:30–54. © 2015 American Cancer Society.
American Cancer Society Guidelines for the Early Detection of Cancer, 2005
Authors: R. A. Smith, V. Cokkinides, H. J. Eyre
Journal: CA A Cancer Journal for Clinicians (2005)

Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2004, there were no updates to ACS guidelines. In this article, we summarize the current guidelines, discuss recent evidence and policy changes that have implications for cancer screening, and provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and insurance status from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.
The Effects of Growth Hormone on Body Composition and Physical Performance in Recreational Athletes
Authors: Udo Meinhardt
Journal: Annals of Internal Medicine (2010)

Background: Growth hormone is widely abused by athletes, frequently with androgenic steroids. Its effects on performance are unclear. Objective: To determine the effect of growth hormone alone or with testosterone on body composition and measures of performance. Design: Randomized, placebo-controlled, blinded study of 8 weeks of treatment followed by a 6-week washout period. Randomization was computer-generated with concealed allocation. (Australian–New Zealand Clinical Trials Registry registration number: ACTRN012605000508673) Setting: Clinical research facility in Sydney, Australia. Participants: 96 recreationally trained athletes (63 men and 33 women) with a mean age of 27.9 years (SD, 5.7). Intervention: Men were randomly assigned to receive placebo, growth hormone (2 mg/d subcutaneously), testosterone (250 mg/wk intramuscularly), or combined treatments. Women were randomly assigned to receive either placebo or growth hormone (2 mg/d). Measurements: Body composition variables (fat mass, lean body mass, extracellular water mass, and body cell mass) and physical performance variables (endurance [maximum oxygen consumption], strength [dead lift], power [jump height], and sprint capacity [Wingate value]). Results: Body cell mass was correlated with all measures of performance at baseline. Growth hormone significantly reduced fat mass, increased lean body mass through an increase in extracellular water, and increased body cell mass in men when coadministered with testosterone. Growth hormone significantly increased sprint capacity, by 0.71 kJ (95% CI, 0.1 to 1.3 kJ; relative increase, 3.9% [CI, 0.0% to 7.7%]) in men and women combined and by 1.7 kJ (CI, 0.5 to 3.0 kJ; relative increase, 8.3% [CI, 3.0% to 13.6%]) when coadministered with testosterone to men; other performance measures did not significantly change. The increase in sprint capacity was not maintained 6 weeks after discontinuation of the drug. Limitations: Growth hormone dosage may have been lower than that used covertly by competitive athletes. The athletic significance of the observed improvements in sprint capacity is unclear, and the study was too small to draw conclusions about safety. Conclusion: Growth hormone supplementation influenced body composition and increased sprint capacity when administered alone and in combination with testosterone. Primary Funding Source: The World Anti-Doping Agency.
Incidence of Endometrial Cancer in Relation to the Use of Oral Contraceptives
Authors: Noel S. Weiss, Tom A. Sayvetz
Journal: New England Journal of Medicine (1980)

Female residents of King and Pierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975–77 were interviewed concerning prior use of oral contraceptives. Their responses were compared with those of a random sample of women from the same population. Women who had taken Oracon (0.1 mg of ethinyl estradiol and 25 mg of dimethisterone) were estimated to have a risk of endometrial cancer 7.3 times that of other women (P = 0.007). This elevation in risk was not seen in users of other sequential preparations. Women who had used combined oral contraceptives had only 50 per cent of the incidence of endometrial cancer of nonusers (P = 0.05), although the protective effect was not evident among those who subsequently took menopausal estrogens for more than two years. These associations suggest that development of neoplasia in the endometrium can be extremely sensitive to hormonal factors: if an oral contraceptive, like Oracon, emphasizes the estrogenic component, promotion of cancer can result; if, like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can result. (N Engl J Med. 1980; 302:551–4.)
Long-term outcome of endoscopic dilatation in patients with Crohn's disease is not affected by disease activity or medical therapy
Authors: G. Van Assche, C. Thienpont, A. D'Hoore, S. Vermeire, I. Demedts, R. Bisschops, G. Coremans, P. Rutgeerts
Journal: Gut (2009)

<h3>Background</h3> Endoscopic dilatation of Crohn9s disease-related strictures is an alternative to surgical resection in selected patients. The influence of disease activity and concomitant medical therapy on long-term outcomes is largely unknown. <h3>Aim and methods</h3> To study the long-term safety and efficacy of stricture dilatation in a single centre cohort. <h3>Results</h3> Between 1995 and 2006, 237 dilatations where performed in 138 patients (mean age 50.6±13.4, 56% female) for a clinically obstructive stricture (&lt;5 cm, 84% anastomotic). Immediate success of a first dilatation was 97% with a 5% serious complication rate. After a median follow-up of 5.8 years (IQR 3.0–8.4), recurrent obstructive symptoms led to a new dilatation in 46% or surgery in 24%. Niether elevated levels of C-reactive protein nor endoscopic disease activity predicted the need for new intervention. None of the concomitant therapies influenced the outcome. <h3>Conclusion</h3> This largest series ever reported confirms that long term efficacy of endoscopic dilatation of Crohn9s disease outweighs the complication risk. Neither active disease at the time of dilatation nor medical therapy afterwards predict recurrent dilatation or surgery.
The Application of Computer-Based Medical-Record Systems in Ambulatory Practice
Authors: G. Octo Barnett
Journal: New England Journal of Medicine (1984)

In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purposes of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to. They would show subscribers how their money was being spent, what amount of good was really being done with it, or whether the money was not doing mischief rather than good.FLORENCE Nightingale, who voiced this complaint in 1873 in a book entitled Notes on a Hospital, was . . .
Two Self-management Interventions to Improve Hypertension Control
Authors: Hayden B. Bosworth
Journal: Annals of Internal Medicine (2009)

Background: Fewer than 40% of persons with hypertension in the United States have adequate blood pressure (BP) control. Objective: To compare 2 self-management interventions for improving BP control among hypertensive patients. Design: A 2 × 2 randomized trial, stratified by enrollment site and patient health literacy status, with 2-year follow-up. (ClinicalTrials.gov registration number: NCT00123058) Setting: 2 university-affiliated primary care clinics. Patients: 636 hypertensive patients. Intervention: A centralized, blinded, and stratified randomization algorithm was used to randomly assign eligible patients to receive usual care, a behavioral intervention (bimonthly tailored, nurse-administered telephone intervention targeting hypertension-related behaviors), home BP monitoring 3 times weekly, or the behavioral intervention plus home BP monitoring. Measurements: The primary outcome was BP control at 6-month intervals over 24 months. Results: 475 patients (75%) completed the 24-month BP follow-up. At 24 months, improvements in the proportion of patients with BP control relative to the usual care group were 4.3% (95% CI, −4.5% to 12.9%) in the behavioral intervention group, 7.6% (CI, −1.9% to 17.0%) in the home BP monitoring group, and 11.0% (CI, 1.9%, 19.8%) in the combined intervention group. Relative to usual care, the 24-month difference in systolic BP was 0.6 mm Hg (CI, −2.2 to 3.4 mm Hg) for the behavioral intervention group, −0.6 mm Hg (CI, −3.6 to 2.3 mm Hg) for the BP monitoring group, and −3.9 mm Hg (CI, −6.9 to −0.9 mm Hg) for the combined intervention group; patterns were similar for diastolic BP. Limitation: Changes in medication use and diet were monitored only in intervention participants; 24-month outcome data were missing for 25% of participants, BP control was adequate at baseline in 73% of participants, and the study setting was an academic health center. Conclusion: Combined home BP monitoring and tailored behavioral telephone intervention improved BP control, systolic BP, and diastolic BP at 24 months relative to usual care. Primary Funding Source: National Heart, Lung, and Blood Institute; Pfizer Foundation Health Communication Initiative; and the American Heart Association.
Decisions Near the End of Life
Authors: Richard J. McMurray
Journal: JAMA (1992)

OVER the last 50 years, people have become increasingly concerned that the dying process is too often needlessly protracted by medical technology and is consequently marked by incapacitation, intolerable pain, and indignity. In one public opinion poll, 68% of respondents believed that "people dying of an incurable painful disease should be allowed to end their lives before the disease runs its course."<sup>1</sup>A number of comparable surveys indicate similar public sentiment.<sup>2</sup> Since the turn of the century, there has been a dramatic shift in the places where people die. Sixty years ago, the vast majority of deaths occurred at home. Now most people die in hospitals or long-term care facilities. Approximately 75% of all deaths in 1987 occurred in hospitals and long-term care institutions,<sup>3</sup>up from 50% in 1949,61% in 1958, and 70% in 1977.<sup>4</sup>This transition from the privacy of the home to medical institutions
Meta-analysis: Effects of Percutaneous Coronary Intervention Versus Medical Therapy on Angina Relief
Authors: Harindra C. Wijeysundera
Journal: Annals of Internal Medicine (2010)

Background: Several meta-analyses have evaluated the efficacy of percutaneous coronary intervention (PCI) compared with medical therapy, but none has focused on angina relief. Purpose: To summarize the evidence on the degree of angina relief from PCI compared with medical therapy in patients with stable coronary artery disease. Data Sources: The Cochrane Library (1993 to June 2009), EMBASE (1980 to June 2009), and MEDLINE (1950 to June 2009), with no language restrictions. Study Selection: Two independent reviewers screened citations to identify randomized, controlled trials of PCI versus medical therapy in patients with stable coronary artery disease. Data Extraction: Two independent reviewers abstracted data on patient characteristics, study conduct, and outcomes. A random-effects model was used to combine data on freedom from angina and to perform stratified analyses based on duration of follow-up, inclusion of patients with recent myocardial infarction, coronary stent utilization, recruitment period, and utilization of evidence-based medications. Data Synthesis: A total of 14 trials, enrolling 7818 patients, met the inclusion criteria. Although PCI was associated with an overall benefit on angina relief (odds ratio, 1.69 [95% CI, 1.24 to 2.30]), important heterogeneity across trials was observed. The incremental benefit of PCI observed in older trials (odds ratio, 3.38 [CI, 1.89 to 6.04]) was substantially less and possibly absent in recent trials (odds ratio, 1.13 [CI, 0.76 to 1.68]). An inverse relationship between use of evidence-based therapies and the incremental benefit of PCI was observed. Limitations: Information about the long-term use of medication was incomplete in most trials. Few trials used drug-eluting stents. Meta-regression analyses used aggregated study-level data from few trials. Conclusion: Percutaneous coronary intervention was associated with greater freedom from angina compared with medical therapy, but this benefit was largely attenuated in contemporary studies. This observation may be related to greater use of evidence-based medications in contemporary trials. Primary Funding Source: Canadian Institutes of Health Research.
Long-term Safety and Efficacy of Closure of Mesenteric Defects in Laparoscopic Gastric Bypass Surgery
Authors: Erik Stenberg, Johan Ottosson, Anders Magnuson, Eva Szabo, Stefan Wallén, Erik Näslund, Anders Thorell, Ingmar Näslund
Journal: JAMA Surgery (2023)

Short-term and midterm data suggest that mesenteric defects closure during laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery reduces the risk of internal herniation with small bowel obstruction (SBO) but may increase risk of kinking of the jejunojejunostomy in the early postoperative period. However, to our knowledge, there are no clinical trials reporting long-term results from this intervention in terms of risk for SBO or opioid use.
Microbiota transplant to control inflammation in a patient with NLRC4 gain-of-function–induced disease
Authors: Claudia Bracaglia, Giulia Marucci, Federica Del Chierico, Alessandra Russo, Manuela Pardeo, Denise Pires Marafon, Andrea Quagliariello, Ivan Caiello, Francesca Rea, Sarka Fingerhutova, Antonella Insalaco, Giusi Prencipe, Pavla Dolezalova, Fabrizio De Benedetti, Lorenza Putignani
Journal: Journal of Allergy and Clinical Immunology (2023)
Time-Limited Initial Therapy for Young, Fit Patients with CLL
Authors: Jennifer A. Woyach, John C. Byrd
Journal: New England Journal of Medicine (2023)

First-line treatment for chronic lymphocytic leukemia (CLL) has changed dramatically over the past decade. The introduction of the covalent Bruton's tyrosine kinase (BTK) inhibitor ibrutinib, which has been shown to be superior to chemotherapy or chemoimmunotherapy with respect to progression-free survival, has been transformative.1-3 Subsequently, two second-generation BTK inhibitors (acalabrutinib and zanubrutinib) have been shown to have efficacy that is at least similar to that of ibrutinib, with better safety. In parallel, the B-cell lymphoma 2 (BCL2) antagonist venetoclax has been shown to have considerable efficacy in relapsed CLL. In a phase 3 trial, untreated patients with CLL and coexisting . . .
Orchestrated Strategies for Developing Fluorophores for NIR‐II Imaging
Authors: Xin Feng, Long Wei, Yanlin Liu, Xiaoyuan Chen, Rui Tian
Journal: Advanced Healthcare Materials (2023)

Abstract Fluorescence imaging (FLI), a non‐invasive, real‐time, and highly sensitive imaging modality, allows for investigating the molecular/cellular level activities to understand physiological functions and diseases. The emergence of the second near‐infrared window (NIR‐II, 1000–1700 nm) has endowed fluorescence imaging with deeper tissue penetration and unprecedented clarity. Among the various NIR‐II imaging fluorophores, the organic fluorescent probes have occupied a pivotal position in bioimaging due to their higher biocompatibility, safety, and potential for clinical applications compared with those of the inorganic probes. To obtain high‐quality organic dyes, diverse strategies have been taken. In this review, different strategies for optimizing NIR‐II organic fluorophores are summarized, including traditional chemical modifications, and emerging bioengineering operations, which have not previously been elaborated on and summarized. Moreover, the bioengineering strategies are highlighted using endogenous serum proteins and even exogenous gene‐editing proteins, which would provide fresh insights to design good‐performance dyes and help develop NIR‐II probes with clinical translation potential in the future. A critical perspective on the direction of the design strategies of NIR‐II dyes for disease imaging is also proposed.
Discovery of an orally effective double-stapled peptide for reducing ovariectomy-induced bone loss in mice
Authors: Wei Cong, Huaxing Shen, Xiufei Liao, Mengjun Zheng, Xianglong Kong, Zhe Wang, Si Chen, Yulei Li, Honggang Hu, Xiang Li
Journal: Acta Pharmaceutica Sinica B (2023)

Stapled peptides with significantly enhanced pharmacological profiles have emerged as promising therapeutic molecules due to their remarkable resistance to proteolysis and performance to penetrate cells. The all-hydrocarbon peptide stapling technique has already widely adopted with great success, yielding numerous potent peptide-based molecules. Based on our prior efforts, we conceived and prepared a double-stapled peptide in this study, termed FRNC-1, which effectively attenuated the bone resorption capacity of mature osteoclasts in vitro through specific inhibition of phosphorylated GSK-3β. The double-stapled peptide FRNC-1 displayed notably improved helical contents and resistance to proteolysis than its linear form. Additionally, FRNC-1 effectively prevented osteoclast activation and improved bone density for ovariectomized (OVX) mice after intravenous injection and importantly, after oral (intragastric) administration. The double-stapled peptide FRNC-1 is the first orally effective peptide that has been validated to date as a therapeutic candidate for postmenopausal osteoporosis (PMOP).
Evaluation of a single-use gastroscope in patients presenting with suspected upper gastrointestinal hemorrhage: a pilot feasibility study (One-Scope I)
Authors: Alanna Ebigbo, Vidan Tadic, Jakob Schlottmann, Georg Braun, Friederike Prinz, Julia Wanzl, Mousa Ayoub, Lisa Kraus, Markus Scheppach, Sandra Nagl, Elisabeth Schnoy, Tobias Weber, Andreas Probst, Helmut Messmann, Christoph Römmele
Journal: Endoscopy (2023)

BACKGROUND : Outbreaks of multidrug-resistant bacteria due to contaminated duodenoscopes and infection risks during the COVID-19 pandemic have driven the development of single-use endoscopes. The first single-use gastroscope is now available in Europe. Besides waste disposal and cost issues, the infection risk and performance remain unclear. We aimed to evaluate a single-use gastroscope in patients with signs of upper gastrointestinal bleeding. METHODS : 20 consecutive patients presenting with clinical signs of upper gastrointestinal bleeding between October and November 2022 were included in this case series. The primary aim was technical success, defined as access to the descending duodenum and adequate assessment of the upper gastrointestinal tract for the presence of a bleeding site. RESULTS : The primary aim was achieved in 19/20 patients (95 %). The bleeding site was identified in 18 patients. A therapeutic intervention was performed in six patients (two cap-mounted clips, one standard hemostatic clip, two variceal band ligations, one hemostatic powder, two adrenaline injections); technical and clinical success were achieved in all six patients. Two crossovers to a standard gastroscope occurred. CONCLUSIONS : Use of single-use gastroscopes may be feasible for patients presenting for urgent endoscopic evaluation and treatment of upper gastrointestinal bleeding.